Mini Lung Transplant

J. G.. Miller, M. G.. Haske, C. Mangukia
Loyola University Medical Center, Maywood, Illinois

Please explain the educational or technical point that this video addresses.: We perform mini lung transplants through a 5cm incision and mini thoracotomy with some slight modifications to our standard lung transplant procedure. We aim to educate other transplant surgeons on ways to modify their patient positioning, instruments, and surgical techniques to also be able to replicate mini lung transplants.

Please provide a 250 word summary of the surgical video being submitted.: The patient is positioned in a lazy lateral position and selective left lung ventilation is established. A 5cm incision is made under the right breast and a right anterolateral thoracotomy is performed through 4th intercostal space and a small Finochietto is used for retraction. The hilum is dissected and the inferior pulmonary ligament is lysed. Femoral VA ECMO is utilized to facilitate anatomical exposure and hemodynamic stability. Umbilical tapes are placed around the vascular hilar structures and they are divided with a GIA stapler. The bronchus is divided with electrocautery. After the pneumonectomy and recipient hilar preparation, the donor lung is brought onto the field and back table preparation is performed. The bronchial, pulmonary artery, and pulmonary vein anastomoses are completed using PDS 4–0. The lung is deaired and clamps are released. Chest tubes are placed after confirming hemostasis. The patient is weaned from VA ECMO and the chest is closed in layers. Final incision measures 5 cm